English Language Pre-Medical Program for Hungarian Universities ...
English Language Pre-Medical Program for Hungarian Universities ... English Language Pre-Medical Program for Hungarian Universities ...
English Language Pre-Medical Programfor Hungarian UniversitiesAPPLICATION FORMTo Begin Studies in October 20121. Type or block print all information.2. These items should be attached to the application:a, School Leaving Certificate and official transcripts from yoursecondary school (with an authorized translation).b, Letters of recommendation.c, Four passport size photos.d, Bank receipt for EUR 200 (non refundable).e, Medical report (including negative HIV test).f, Curriculum Vitae in English (attach separate page).g, Copy of passport.3. Sign the application on page 2.4. Submit all application to your local representative. If nothing isindicated send it directly to McDaniel College Pre-Med ProgramOffice, H-1406 Budapest 76, P.O. Box 51, HungaryPHOTO (signed)Clip. Do not glue,tape or stapleDeadline:September 1, 2012I apply for ❑ Medicine ❑ Dentistry ❑ Pharmacy ❑ Veterinary Science❑ Nursing ❑ Midwifery ❑ PhysiotherapyPlease, tick (✓) the appropriate box.Family Name (Surname)First Name (Given name)Please, write your name as written in the passport.Sex (F/M) Birthdate (D/M/Y) Birthplace (City / Country) Passport / ID card No.Citizenship*Mother’s full maiden namePermanent Address (No. / Street / City / Town / Postal Code / Country)Phone or Mobile phone or FaxE-mailI first learnt about the program in Hungary:❑ from a Budapest student ❑ from the media ❑ from the Internet ❑ from my high school❑ from the local representative ❑ from an acquaintance ❑ at an educational fair/seminar ❑ from ANSA* If you have a dual citizenship please underline that country’s, whose passport you will use when entering Hungary.
<strong>English</strong> <strong>Language</strong> <strong>Pre</strong>-<strong>Medical</strong> <strong>Program</strong><strong>for</strong> <strong>Hungarian</strong> <strong>Universities</strong>APPLICATION FORMTo Begin Studies in October 20121. Type or block print all in<strong>for</strong>mation.2. These items should be attached to the application:a, School Leaving Certificate and official transcripts from yoursecondary school (with an authorized translation).b, Letters of recommendation.c, Four passport size photos.d, Bank receipt <strong>for</strong> EUR 200 (non refundable).e, <strong>Medical</strong> report (including negative HIV test).f, Curriculum Vitae in <strong>English</strong> (attach separate page).g, Copy of passport.3. Sign the application on page 2.4. Submit all application to your local representative. If nothing isindicated send it directly to McDaniel College <strong>Pre</strong>-Med <strong>Program</strong>Office, H-1406 Budapest 76, P.O. Box 51, HungaryPHOTO (signed)Clip. Do not glue,tape or stapleDeadline:September 1, 2012I apply <strong>for</strong> ❑ Medicine ❑ Dentistry ❑ Pharmacy ❑ Veterinary Science❑ Nursing ❑ Midwifery ❑ PhysiotherapyPlease, tick (✓) the appropriate box.Family Name (Surname)First Name (Given name)Please, write your name as written in the passport.Sex (F/M) Birthdate (D/M/Y) Birthplace (City / Country) Passport / ID card No.Citizenship*Mother’s full maiden namePermanent Address (No. / Street / City / Town / Postal Code / Country)Phone or Mobile phone or FaxE-mailI first learnt about the program in Hungary:❑ from a Budapest student ❑ from the media ❑ from the Internet ❑ from my high school❑ from the local representative ❑ from an acquaintance ❑ at an educational fair/seminar ❑ from ANSA* If you have a dual citizenship please underline that country’s, whose passport you will use when entering Hungary.
ACADEMIC RECORD1. List all secondary schools attendedDates AttendedDiploma/Name of School Location From To Certificate2. Date and place of high school /senior secondary school exam:Certificate issued by:No:3. Sciences studied (please underline!): Biology – Chemistry – Physics4. Activity following graduation, if any:5. What is your mother tongue?Other languages? Speak: Read: Write:<strong>Hungarian</strong>? Speak: Read: Write:PERSONAL INFORMATION6. Your Marital Status7. Father’s name OccupationAddressMother’s maiden nameOccupationAddress8. Person to notify in emergency:Name Relationship Daytime PhoneAddress (No. / Street / City / Postal Code / Country)Daytime Fax9. CURRICULUM VITAE. Attach separate page!I hereby certify that all in<strong>for</strong>mation provided by me in this application is accurate and complete. I declarethat I am fully aware of the contents of the official program brochure and fully accept the given conditions.(Signed)Date:
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